Healthcare Provider Details
I. General information
NPI: 1609830744
Provider Name (Legal Business Name): TOTAL RENAL CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/14/2006
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5820 ROAD 68
PASCO WA
99301-5677
US
IV. Provider business mailing address
5200 VIRGINIA WAY L&C DEPT
BRENTWOOD TN
37027-7569
US
V. Phone/Fax
- Phone: 509-410-6201
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QE0700X |
| Taxonomy | End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SAMUEL
T
WEY
Title or Position: VP LICENSURE & CERTIFICATION
Credential:
Phone: 615-341-6641